Individual
LYNNS CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5851 S VICKERY, CUMMING, GA 30040-8793
(678) 648-5185
Mailing address
600 VENUE WAY APT 6312, ALPHARETTA, GA 30005-4553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003358
GA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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